Samuel Grady Putnam, MD

Primary specialty

Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X

License

28916 Issued in MS

Practice address

55 Physicians LN
Southaven, MS 38671-9569

Phone

(662) 655-2136

Fax

(662) 996-2214

NPI assigned

May 5, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 9

Addresses

Other identifiers 9

Medicare fee-for-service enrollment

Enrolled in PA, NJ, DE, MS, CO, TN, IN, TX, AZ, SD, ND, IL, GA, HI, AL16 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 16

Specialty

Interventional RadiologyAlso: Diagnostic Radiology

Education

Other, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Geisinger ClinicGroup PAC ID 5395657001, 3,432 clinicians

Hilo Benioff Medical CenterGroup PAC ID 1254422900, shared by 4 NPIs, 131 clinicians

Kau HospitalGroup PAC ID 7416945548, shared by 9 NPIs, 138 clinicians

USA Health Physician Billing Services LLCGroup PAC ID 9931436912, 342 clinicians

Sanford BismarckGroup PAC ID 9739098575, 562 clinicians

Carle Health Care IncorporatedGroup PAC ID 3577515774, 1,592 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• USA Health University Hospital Hospital, Mobile, AL, CCN 010087
• Geisinger-Lewistown Hospital Hospital, Lewistown, PA, CCN 390048
• Carle Foundation Hospital Hospital, Urbana, IL, CCN 140091
• Hilo Benioff Medical Center Hospital, Hilo, HI, CCN 120005
• Sanford Medical Center Bismarck Hospital, Bismarck, ND, CCN 350015

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations (25 of 26)

Interoperability endpoints

• Direct secure messaging: samuelputnam@fu.allscriptsdirect.net
• Direct secure messaging: sputnammd422528@carlehiedirect.net
• Direct secure messaging: samuel.putnam.1@12833.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Carle Health Care Incorporated

  • Internal Medicine Physician
  • Urbana, IL
  • NPI 1154653947
  Medicare reassignment Care Compare group NPD
• Geisinger Clinic

  • Family Medicine Physician
  • Danville, PA
  • NPI 1366493868
  Medicare reassignment Care Compare group NPD
• Sanford Bismarck

  • Multi-Specialty Clinic/Center
  • Bismarck, ND
  • NPI 1811941172
  Medicare reassignment Care Compare group NPD
• USA Health Physician Billing Services LLC

  • Internal Medicine Physician
  • Mobile, AL
  • NPI 1720645468

  Diagnostic Radiology

  Medicare reassignment Care Compare group NPD
• Advanced Urology, PLLC

  • Urology Physician
  • Lone Tree, CO
  • NPI 1962501551
  Medicare reassignment NPD
• Capital Health Multispecialty Group

  • Surgery Physician
  • Trenton, NJ
  • NPI 1083072342

  Diagnostic Radiology

  Medicare reassignment NPD
• Christiana Care Health Services Inc

  • Cardiovascular Disease Physician
  • West Grove, PA
  • NPI 1659547560
  Medicare reassignment NPD
• Christiana Care Health Services Inc

  • Vascular & Interventional Radiology Physician
  • Wilmington, DE
  • NPI 1679727028

  Diagnostic Radiology

  Medicare reassignment NPD
• Christiana Care Health Services Inc

  • Diagnostic Radiology Physician
  • Newark, DE
  • NPI 1942553615
  Medicare reassignment NPD
• Christiana Care Health Services, Inc

  • Endocrinology, Diabetes & Metabolism Physician
  • Wilmington, DE
  • NPI 1770568107
  Medicare reassignment NPD
• Geisinger-HM Joint Venture, LLC

  • Family Medicine Physician
  • Lock Haven, PA
  • NPI 1144876137

  Diagnostic Radiology

  Medicare reassignment NPD
• Guthrie Medical Group, P.C.

  • Family Medicine Physician
  • Athens, PA
  • NPI 1962451153
  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Carle Surgicenter

  • Ambulatory Surgical Clinic/Center
  • Danville, IL
  • NPI 1225194533

  Hospital

  Care Compare affiliation
• Geisinger Lewistown Hospital

  • Clinic/Center
  • Lewistown, PA
  • NPI 1265207187

  Hospital

  Care Compare affiliation
• Geisinger Lewistown Hospital

  • General Acute Care Hospital
  • Lewistown, PA
  • NPI 1497338313
  Care Compare affiliation
• Geisinger Lewistown Hospital

  • Radiology Clinic/Center
  • Mifflintown, PA
  • NPI 1609263946

  Hospital

  Care Compare affiliation
• Geisinger Lewistown Hospital

  • Radiology Clinic/Center
  • Lewistown, PA
  • NPI 1689061921

  Hospital

  Care Compare affiliation
• Geisinger Lewistown Hospital

  • Mobile Radiology Clinic/Center
  • Lewistown, PA
  • NPI 1750778981

  Hospital

  Care Compare affiliation
• Geisinger Lewistown Hospital

  • Ambulatory Surgical Clinic/Center
  • Port Matilda, PA
  • NPI 1801531322

  Hospital

  Care Compare affiliation
• Geisinger Lewistown Hospital

  • Psychiatric Hospital Unit
  • Lewistown, PA
  • NPI 1831242114
  Care Compare affiliation
• Geisinger Lewistown Hospital

  • Clinic/Center
  • State College, PA
  • NPI 1841970746

  Hospital

  Care Compare affiliation
• Geisinger Lewistown Hospital

  • General Acute Care Hospital
  • Lewistown, PA
  • NPI 1861545683
  Care Compare affiliation
• Hilo Benioff Medical Center

  • General Acute Care Hospital
  • Hilo, HI
  • NPI 1780757856
  Care Compare affiliation
• Sanford Bismarck

  • General Acute Care Hospital
  • Bismarck, ND
  • NPI 1538245634
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746489600000",
    "number": "1023066404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26500 AGOURA RD STE 102-587",
            "city": "CALABASAS",
            "state": "CA",
            "postal_code": "913021952",
            "telephone_number": "818-880-8605",
            "fax_number": "818-579-7916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 PHYSICIANS LN",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386719569",
            "telephone_number": "662-655-2136",
            "fax_number": "662-996-2214"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "750 Brunswick Ave",
            "address_purpose": "LOCATION",
            "city": "Trenton",
            "state": "NJ",
            "postal_code": "086384143",
            "country_code": "US",
            "telephone_number": "609-394-6000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1120 15th St",
            "address_purpose": "LOCATION",
            "city": "Augusta",
            "state": "GA",
            "postal_code": "309129569",
            "country_code": "US",
            "telephone_number": "706-721-8623",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Capital Way",
            "address_purpose": "LOCATION",
            "city": "Pennington",
            "state": "NJ",
            "postal_code": "085342520",
            "country_code": "US",
            "telephone_number": "609-303-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PUTNAM",
        "first_name": "SAMUEL",
        "middle_name": "GRADY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-05",
        "last_updated": "2025-05-06",
        "certification_date": "2025-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NJ",
            "license": "25MA09575600",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MD041221E",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "DE",
            "license": "C1-0011573",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "PA",
            "license": "MD041221E",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "NJ",
            "license": "25MA09575600",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "TN",
            "license": "63241",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "HI",
            "license": "MD-23034",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "DE",
            "license": "C1-0011573",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "MS",
            "license": "28916",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "1172545",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE MERCY",
            "identifier": "30026885",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0012723560016",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH/INTERCOUNTY",
            "identifier": "0546464000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRM",
            "identifier": "300099781",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "7929044",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IBC - PC/KHPE",
            "identifier": "0546464000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "710371",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA HMO/PPO",
            "identifier": "8215722",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Psycamore LLC
• Psycamore, LLC
• Christopher Matthew Garrett Puls, MD
• Karen Kamillah Purnell, PMHNP
• Kay S Purnell
• Muneeba Qayyum, MD
• Quality Drug Testing, LLC
• Quality Foot Care LLC
• Trevor Lamar Qualls, D.C.
• Tyler Lane Qualls, D.C.

• Vascular & Interventional Radiology Physician in Southaven, MS
• Providers in Southaven, MS by specialty
• Vascular & Interventional Radiology Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.